Background: Lumbar facet joints have been implicated as the source of chronic pain in
15% to 45% of patients with chronic low back pain. Various therapeutic techniques including intraarticular injections, medial branch blocks, and radiofrequency neurotomy of lumbar facet joint nerves have been described in the alleviation of chronic low back pain of facet joint origin.
Objective: The study was conducted to determine the clinical effectiveness of therapeutic
local anesthetic lumbar facet joint nerve blocks with or without steroid in managing chronic
function-limiting low back pain of facet joint origin.
Design: A randomized, double-blind, controlled trial.
Setting: An interventional pain management setting in the United States.
Methods: This study included 60 patients in Group I with local anesthetic and 60 patients
in Group II with local anesthetic and steroid. The inclusion criteria was based on the positive response to the diagnostic controlled comparative local anesthetic lumbar facet joint
blocks.
Outcome measures: Numeric pain scores, Oswestry Disability Index, opioid intake, and
work status. All outcome assessments were performed at baseline, 3 months, 6 months,
and 12 months.
Results: Significant improvement with significant pain relief (> 50%) and functional improvement (> 40%) were observed in 82% and 85% in Group I, with significant pain relief
in over 82% of the patients and improvement in functional status in 78% of the patients.
Based on the results of the present study, it appears that patients may experience significant
pain relief 44 to 45 weeks of 1 year, requiring approximately 3 to 4 treatments with an average relief of 15 weeks per episode of treatment.
Conclusion: Therapeutic lumbar facet joint nerve blocks, with or without steroid, may provide a management option for chronic function-limiting low back pain of facet joint origin.
Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet joint
nerve or medial branch blocks, comparative controlled local anesthetic blocks, therapeutic
lumbar facet joint nerve blocks
Fluoroscopy-guided percutaneous rupture of lumbar facet joint synovial cyst: An alternative to surgery
